Paraneoplastic Syndromes and random stuff at end of lecture Flashcards Preview

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Flashcards in Paraneoplastic Syndromes and random stuff at end of lecture Deck (26)
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1
Q

Name the endocrinopathies

A
Cushings
Hypercalcemia
SIADH
Hypoglycemia
Polycythemia
2
Q

Paraneoplastic Cushings

A

*DX: Increased ACTH AND POMC

mostly from small cell lung cancer

see HTN and decreased serum K (more than other cushings)

3
Q

Paraneoplastic Hypercalcemia

A

*Most common paraneoplastic and VERY life-threatening metabolic disorder in cancer patients

Typically lung cancer (or breast)

Tumor makes PTHRP which acts like PTH and activates osteolysis so get increased Calcium, decreased PTH and increased PTHRP

Symptoms = weakness, confusion, lethargy, constipation

4
Q

Paraneoplastic SIADH

A

Seen with small cell lung cancer or intracranial cancer

Causes hyponatremia from all the water reabsorption
**Cerebral edema it causes can be lethal

5
Q

Paraneoplastic Hypoglycemia

A

Typically from Soft Tissue Sarcomas and Hepatocellular carcinomas that make insulin-like proteins

6
Q

Paraneoplastic Polycythemia

A

EPO made from tumors of breast or lungs

*Clotting and thrombosis can occur

7
Q

Name the other, non-endocrine, paraneoplastic syndromes

A
Hypertrophic Osteoarthropathy
Acanthosis Nigricans
Neuromyopathic syndrome
DIC
Non-bacterial thrombotic endocarditis
Trouseau Syndrome
8
Q

Paraneoplastic Hypertrophic Osteoarthropathy

A

Lung Cancer

TRIAD Presentation: 1) new bone formation in long bones and bones of fingers 2) arthritis of adjacent joints and 3) Clubbing of fingers

9
Q

Paraneoplastic Anathosis Nigricans

A

NEW presentation (can be benign from previous)

Gray/black patches of hyperkeratosis present in certain skin areas

Increased EGF production by Lung or Gastric Tumors

10
Q

Paraneoplastic Neumyopathic syndrome

A

Tumor antigens are similar to nerves and so body makes anti-nerve cell antibodies leading to peripheral neuropathy, corticocerebellar lesions, polymyopathy, and EATON LAMBERT

Eaton Lambert = Myasthenic syndrome and suspect if no thymoma or autoimmune disease

11
Q

Paraneoplastic Vascular - DIC

A
  • APL = large promyelocytes with increased granules and granule contents induce coagulation cascade
  • Prostate cancer with increased mucins to activate cascade
12
Q

Paraneoplastic Vascular - NBTE

A

Non-Bact Thrombotic Endocarditis

Fibrinous deposits/vegetations on heart valves from pro-coagulation effects that can be bad and send emboli to the brain

13
Q

Paraneoplasti Vascular - Trousseau Syndrome

A

migratory superficial thrombophlebitis with migratory crops of tender nodules in veins

From Deep-seeded cancers - Pancreas or Lung
make increased mucins to activate clotting

14
Q

Tumor Markers

A

not for diagnostics (can support diagnostics) but used in association with cancer and can be used to follow treatment

15
Q

PSA

A

Prostate cancer marker and for Screening!

16
Q

CEA

A

colon and pancreas marker (along with CA19-9)

17
Q

CA19-9

A

Colon and pancreas marker (along with CEA)

18
Q

AFP

A

Liver and Testes marker

remember Alcohol For Penis

19
Q

CA-125

A

Ovarian cancer marker

20
Q

HCG

A

Testicular cancer marker

21
Q

FML4-ALK

A

Fusion marker of genes in lung cancer

(+) predictive with ALK inhibitor Crisotinib

22
Q

V600E of BRAF

A

Molecular marker in Melanoma

+Predictor for BRAF inhibitor

23
Q

EGFR

A

+predictive molecular marker for Erlotinib

24
Q

RAS

A

Negative prognostic marker

negative predictive marker for treatment of colon cancer with Cetuximab

25
Q

Crisotinib

A

treatment for FML4-ALK fusion gene in lung cancer

ALK inhibitor

26
Q

Erlotinib

A

Antibody to treat EGFR cancers